Department of Obstetrics and Gynecology Feinberg School of Medicine

Choosing a Career in

Obstetrics & Gynecology A guide to residency application

making a difference across the lifecycle

January 15th, 2013

Welcome to the Ob-Gyn Specialty Session! There is nothing more exciting or daunting than selecting an area of medicine in which to practice. Our department’s pledge to you is to first and foremost provide you with an exceptional opportunity to learn the knowledge and skills basic to our field of reproductive and women’s health. Secondly we stand ready to assist you in your journey to explore career options, select a specialty that is rewarding and fulfilling, apply for residency and successfully match at a program that is right for you. Tonight is just the first night in a very long process that will culminate when you rip open an envelope about 13 months from now. Tonight, we will focus on how and why we made the choice of ObGyn and provide you with the basic facts ….the nature of our specialty, what residency training encompasses and what factors are associated with matching in a good program. We will address what you can do to maximize your chance of successfully getting the residency you desire and how to prepare for residency during the fourth year. BUT, while the formal process of career selection begins tonight, it certainly does not end here. We expect that whether you end up applying in ObGyn or not, an advisor from our department can help you with your career deliberations. While a specific faculty advisor will be assigned to you, it does take a village…. so remember, every one of our 47 residents, 10 fellows and 200 faculty members is available to speak with you about our specialty. If you would like to explore a particular aspect of our specialty that you were not yet exposed to, we can arrange for you to spend time in REI, MFM, Family Planning, Genetics, UroGyn, Gyn Oncology, an ObGyn Research Lab or a private practice setting. Once you have an advisor, they will meet with you to begin the process of helping you to schedule your fourth year electives, identify potential faculty to write letters of recommendation, help you to prepare and refine your personal statement and explore specific residency programs. We will hold 3 more specialty sessions over the next 15 months: 1) a session devoted to an overview of residency programs across the country and how to evaluate them, 2) a session devoted to preparing you for interviews led by the residents, and 3) a “boot camp” skills session for M4s who have matched in ObGyn to prepare them for internship. Each student will meet with our Chairperson, Dr. Serdar Bulun and he will write one of your letters of recommendation. Each of us here tonight is sincerely committed to your successful quest to find the right program in the right area of medicine that will make you the happiest and most fulfilled. For me, this picture says it all……how can 6 people be so happy at 3:00am? Simply put, ObGyn is the most diverse, compelling and profoundly satisfying area of medicine in which to make a difference…for our patients, our community and the world. On behalf of the entire Dept. of ObGyn, Good Luck!

Northwestern Obstetrics and Gynecology.. ….a proud heritage

Augusta Webster John Sciarra

Beatrice Tucker

Albert Gerbie Sharon Dooley John Brewer Sherman Elias Serdar Bulun Michael Socol Teresa Woodruff Melissa Simon Bill Grobman Alan Peaceman

What is ObGyn……Is ObGyn right for me? The nature of the work, practice settings, compensation, job outlook Diversity of practice: Medicine/Surgery; Hospital-Based/Office-Based; Generalist/Specialist; High-Acuity/Routine; High-Tech/Hands-On; Individual/Global; Primary Care/Tertiary Care; Acute/Chronic/Preventive; Research-oriented/Patient-Care oriented ; Procedure-Oriented/Counseling-Oriented You can tailor a unique career that’s right for you! 4 year residency

Generalist Practice

Sub-Specialty Fellowship Training

Research training

RSTP Women’s Health Research Fellowship AGOS Fellowship Robert Wood Johnson Fellowship

Maternal-Fetal Medicine

Gynecologic Oncology Reproductive Endocrinology & Infertility

Private Practice 85% (Generalist or Sub-Specialist)

Academic Practice 15% (Generalist or Sub-Specialist) Alternate Career Paths International Health CDC / Public Health Research Scientist

Gynecologic Urology Reproductive Genetics Family Planning* Infectious Diseases* Adolescent Gyne* Minimally Invasive Surgery* Pelvic Pain* / Pelvic Surgery*

Practice Settings for Obstetrician Gynecologists

Private Practice Salaried Position Hospital Employee Solo Practice Single Specialty Group Multi Specialty Group Medical School

70% 15% 11.3% 22.6% 45.2% 14.6% 10%

compensation Clinical Practice

Starting Salaries 1 - 2 Years in Specialty All Physicians

Low (25th Percentile)

Median

High (75th Percentile)

$180,000

$210,000

$246,000

N/A

$230,000

N/A

$228,108

N/A

$373,371

Source: MGMA Physician Compensation and Production Survey: 2009 Report Based on 2008 Data, and Physician Placement Starting Salary Survey: 2009 Report Based on 2008 Data. Reprinted with permission from the Medical Group Management Association, 104 Inverness Terrace East, Englewood, Colorado 80112-5306; 303.799.1111. www.mgma.com. Copyright 2009.

workforce / job outlook

Will I match and where?

What is ObGyn training like?

The Education Program The following information is extracted from the ACGME Program Requirements for Residency Education. For more information visit the ACGME website at www.acgme.org. Curriculum: Educational Components 1. The resident's ability to personally evaluate a patient's complaint, provide an accurate examination, employ appropriate diagnostic tests, arrive at a correct diagnosis, and recommend the appropriate treatment is of paramount importance. 2. Formal teaching activities in obstetrics-gynecology should be structured and regularly scheduled. They generally should consist of patient rounds, case conferences, journal clubs, and protected time for didactic conferences covering all aspects of the specialty, including basic sciences pertinent to the specialty. In cross-disciplinary conferences such as perinatology, physicians from appropriate specialties should be invited to participate. 3. Wise judgment regarding the need for a surgical procedure and recognition and management of complications are as important as the technical aspects of residency education. The program must, therefore, ensure that residents' clinical experience emphasizes appropriate involvement in the process that leads to selection of the surgical option, the preoperative assessment, and the postoperative care of the patients for whom they share surgical responsibility. Continuity of care of these patients must be documented. A residency program in obstetrics-gynecology must be able to provide substantial, diverse, and appropriate surgical experience after residents have mastered the basic skills. 4. The program must provide a structured didactic and clinical educational experience in all methods of family planning. Topics must include all reversible methods of contraception, including natural methods, as well as sterilization. This must include experience in management of complications as well as training in the performance of these procedures. This education can be provided outside the institution, in an appropriate facility, under the supervision of appropriately educated faculty. 5. No program or resident with a religious or moral objection shall be required to provide training in or to perform induced abortions. Otherwise, access to experience with induced abortion must be part of residency education. This education can be provided outside the institution. Experience with management of complications of abortion must be provided to all residents. If a residency program has a religious, moral, or legal restriction that prohibits the residents from performing abortions within the institution, the program must ensure that the residents receive satisfactory education and experience in managing the complications of abortion. Furthermore, such residency programs (1) must not impede residents in the programs who do not have religious or moral objections from receiving education and experience in performing abortions at another institution and (2) must publicize such policy to all applicants to those residency programs. 6. Because an increasing percentage of women seeking their medical care from obstetrician-gynecologists are postmenopausal, there must be appropriate didactic instruction and sufficient clinical experience in the management of the problems of women in the post-reproductive age. Specific Educational Experiences The educational curriculum must be written and implemented for the comprehensive development of measurable competencies for each

resident. This education must include but not necessarily be limited to the following:

a. Obstetrics 1) The full range of obstetrics, including the medical and surgical complications of pregnancy and experience in the management of critically ill patients 2) Genetics, including experience with genetic amniocentesis and patient counseling 3) Learning and performing operative vaginal deliveries, including the use of obstetric forceps and/or the vacuum extractor 4) Performing breech and multifetal deliveries 5) Performing vaginal births after previous cesarean delivery 6) Learning the principles of general and conduction anesthesia, together with the management and the complications of these techniques 7) Immediate care of the newborn (Every resident must have experience in resuscitation of the human newborn and understanding of the principles of general neonatal complications.) 8) The full range of commonly employed obstetrical diagnostic procedures, including ultrasonography and other relevant imaging techniques 9) The emotional and psychosocial impact of pregnancy or pregnancy loss on an individual and her family 10) The counseling of women regarding nutrition, exercise, health maintenance, high-risk behaviors, and preparation for pregnancy and childbirth 11) Obstetric pathology

b. Gynecology 1) The full range of medical and surgical gynecology for all age groups, including experience in the management of critically ill patients 2) Diagnosis and management of pelvic floor dysfunction, including experience with various operations for its correction 3) Diagnosis and medical and surgical management of urinary incontinence 4) Oncology, including prevention, diagnosis, and treatment 5) Diagnosis and nonsurgical management of breast disease 6) Reproductive endocrinology and infertility 7) Clinical skills in family planning 8) Psychosomatic and psychosexual counseling 9) The full range of commonly employed gynecologic diagnostic procedures, including ultrasonography and other relevant imaging techniques 10) Counseling and educating patients about the normal physiology of the reproductive tract and about high-risk behaviors that may compromise reproductive function 11) Gynecologic pathology

c. Primary and preventive care 1) Comprehensive history taking, including medical, nutritional, sexual, family, genetic, and social behavior data, and the ability to assess health risks 2) Complete physical examination 3) Appropriate use of laboratory studies and diagnostic techniques 4) Patient education and counseling 5) Screening appropriate to patients of various ages and risk factors 6) Immunizations needed at specific ages and under specific circumstances 7) Diagnosis and treatment of the common nonreproductive illnesses affecting women 8) Continuous management of the health care of women of all ages 9) Appropriate use of community resources and other physicians through consultation when necessary 10) Appropriate awareness and knowledge of the behavioral and societal factors that influence health among women of differing socioeconomic and cultural backgrounds 11) Behavioral medicine and psychosocial problems, including domestic violence, sexual assault, and substance abuse 12) Emergency care 13) Ambulatory primary care problems of the geriatric patient 14) Basics of epidemiology, statistics, data collection and management, and use of medical literature and assessment of its value 15) Ethics and medical jurisprudence 16) Community medicine, including health promotion and disease prevention 17) Health care delivery systems and practice management 18) Information processing and decision making 19) Patient safety

How can I increase my chances of success? 4th year electives – Don’t overload on ObGyn electives; Infectious Diseases, Derm, Rheum, Cards all help to round out your clinical training. You’ll have 4 years to learn ObGyn.

Away rotations - Not necessary; can be helpful if you’re in need of strengthening your application at a particular program or if you want to see a particular program in depth; but, beware as it can be harmful. Research - Not necessary; can be helpful if you’re in need of strengthening your application. CContact Drs. Gossett and Simon asap to link with a faculty member/fellow/resident research project.

Community service / Passion – Always helpful; be creative.

The Process of Residency Application From the AAMC, Careers in Medicine website: https://services.aamc.org/careersinmedicine/ Class Year

Period

Suggested Activities and Tasks

October - March

Year 3





February - June

  

Summer

  

Year 4

July - September

September - October

October - January



Begin working on your curriculum vitae (CV). Crafting a high quality CV can take 8-10 hours, so begin early. Information for the CV can be used in the ERAS application and provided to those writing your letters of recommendation Review the "Charting Outcomes in the Match" report to assess qualifications and competitiveness for different specialties

Review residency programs and physician workforce data through the Specialty Pages and AMA's FREIDA Depending on your school's schedule, make an appointment with your Associate Dean to discuss the MSPE process (At some schools this may occur later in the year) Write your personal statement and have your advisor review it

Obtain your ERAS token (a special code) from your advisor or the Student Affairs dean's office Register with the NRMP for the Main Residency Match Register for early Match, if applicable

Complete the ERAS application using the MyERAS site, including the designation of programs where your application is to be transmitted



Identify additional faculty for writing letters of recommendation

 

Begin preparing for residency interviews

  

If you haven't taken the USMLE Step 2, consider using this time to prepare

MSPE released October 1 Residency interviews Evaluate and compare residency programs by completing the Residency Program Evaluation Guide



Early Match deadlines usually occur in early or mid-January

January - February



Begin entering your Rank Order List for the NRMP match

March



April - June

  

June - July



MATCH DAY -- Typically the Friday in March; results are formally announced at 12:00pm EST

Sign the contract with your residency program Graduate and prepare to begin residency. Congratulations! Begin preparations for moving

Residency begins

THIRTEEN STEPS TO HELP YOU GET A RESIDENCY POSITION 1.

If you are uncertain about your career choice, please schedule a meeting with Dr. Pat Garcia in the Office of Undergraduate Medical Education. We are happy to assign an advisor to

those students who are exploring their options. Requesting an advisor is not a declaration of a career choice. You may do this by calling Mallori Kelley at 312-472-4672. If you know you would like an advisor, please call or email Dr. Garcia and she will assign an advisor to you. All advisors within the department of OB/GYN have been selected due to their special knowledge of OB/GYN residency programs throughout the United States and past experience with residency match program. Please feel free to contact any resident/fellow/faculty member to discuss your thoughts/concerns. If you would like a suggestion of a specific person to meet with or an introduction, please contact Dr. Garcia. 2.

Go to the student/careers section of the APGO website at www.apgo.org (username= directory ; Password= prent78). APGO is the Association of Professors of Gynecology and Obstetrics. The student section of their website contains information about careers in Women’s Health and OB/GYN and a Residency Directory of all US ObGyn programs. (http://www.apgo.org/resources/residencyprogram.html ) It’s a great site, please use it. Two other very good sites are the Careers in Medicine site from the AAMC (https://services.aamc.org/careersinmedicine/) and the FREIDA site (http://www.amaassn.org/ama/pub/education-careers/graduate-medical-education/freida-online.shtml). You should use both of them.

3.

After obtaining an advisor from Dr. Garcia, you should schedule a meeting with that individual. This advisor will serve as an ombudsman for the remainder of the residency search process. Specifically, they will fulfill the following functions: 

The advisor will assist in designing a sequence of senior year clerkships and/or research experiences appropriate to your goals, interests and strengths/weaknesses.



The advisor will discuss different residency programs, indicating advantages and disadvantages of different types of programs (community vs. university based programs, for example) in various parts of the country.



The advisor will help you develop a list of potential programs and direct you to sources of information about those programs.



The advisor will help you develop a strategy for applying within OB/GYN. They will review and make suggestions to your CV and personal statement, and help identify faculty to write letters of recommendation.



The advisor may suggest other members of the faculty with whom you should speak regarding residency applications; especially if other members have particular knowledge of a program in which you are interested.

4.

Develop a plan for the 4th year that includes which electives you need to / want to take depending upon the strengths and weaknesses of your applications.

5.

Prepare to interview mostly in December and January though many programs are now beginning to interview in November. Again, your advisor will help you develop a strategy and conduct a “mock-interview” with you before you begin the real interview process.

6.

Keep your advisor abreast of your residency interviews, reporting any particularly good or bad experiences along the way.

7.

Write a brief letter of thanks to those individuals who interview you at each program.

8.

Complete your application by the required ERAS date.

9.

Though space is limited, an elective in our department may be helpful to develop a good letter of recommendation.

10.

An elective at an extramural institution may or may not help you.

11.

If you want an elective at Northwestern University, apply early.

12.

If you decide to drop, let our office (Undergraduate Education 312/472-4672), Dean Sanguino(Medical Student Affairs 312/503-4070), and the Hospital Course Director know.

13.

We advise that our chairman, Dr. Serdar Bulun be the primary writer for a letter of recommendation. Others can write secondary letters. Make your appointment with Dr. Bulun after August 1st but before September 1st. When you come to Dr. Bulun for a letter, have a package with: a)

biography

b)

evaluations from all clerkships

c)

copies of letters, if possible, from advisors and outside individuals

Department of Obstetrics and Gynecology

Serdar Bulun, MD, Chairman Suite 3-2300, Prentice Women’s Hospital 312/472-3980 Assistant: Julie Ann Henry

Contact Info

Patricia M. Garcia, MD, MPH Director of Undergraduate Medical Education and Medical Student Affairs Rm 1-119, Ward Building, 303 East Chicago Avenue Chicago, Illinois 60611 Assistant: Gladys Soto 312-472-4685 [email protected] Susan Goldsmith, MD Clerkship Director of Undergraduate Medical Education Rm, 5-2178, Prentice, 250 East Superior Street Chicago, Illinois 60611 Assistant: Trudy Beaubrun 312-472-4683 [email protected] Dana Gossett, MD OBGYN Research Course Director Rm, 5-2168, Prentice, 250 East Superior Street Chicago, Illinois 60611 Assistant: Trudy Beaubrun 312-472-4683 [email protected] Melissa Simon, MD OBGYN Research Course Director Rm, 5-2168, Prentice, 250 East Superior Street Chicago, Illinois 60611 Assistant: Trudy Beaubrun 312-472-4683 [email protected] Mallori Kelley Clerkship Coordinator and M4 Counseling Coordinator Rm 5-2179, Prentice, 250 East Superior Chicago, Illinois 60611 312-472-4672 [email protected]

Department Website: http://www.obgyn.northwestern.edu/ If you would like to schedule a meeting to discuss Obstetrics and Gynecology as a career choice, please call Mallori Kelley and she will arrange a time to meet with Dr. Garcia. If you would like an advisor, please contact Dr. Garcia and she will assign one of the following advisors based on your geographic / academic area of interest. If you have worked with one of the faculty and would like to request them as

your advisor, please let us know. You need not be definitely committed to the field in order to be assigned an advisor. The list of current residents and fellows is included at the end of the handbook. You are welcome to contact them for advice as well. ObGyn Faculty Advisors Emily Berry, MD (Gyn Onc)

Prentice 5-2168

312/472-4684

Serdar Bulun, MD (REI/ Basic Research)

Prentice 3-2300

312/472-3970

Sharon L. Dooley, MD, MPH (MFM)

645 N. Michigan, Suite 1058

312/503-7975

Jeff Dungan, MD (Repro Gen)

Prentice 5-2168

312/472-4683

Patricia M. Garcia, MD, MPH

Ward 1-119

312/503-1892

Susan Gerber, MD, MPH (MFM)

Prentice 5-2183

312/472-4685

Melvin Gerbie, MD (Gyne)

680 LSD Building, Suite 1015

312/695-8486

Susan Goldsmith, MD (GeneralObGyn)

Prentice 5-2178

312-472-4672

Dana Gossett, MD (General ObGyn)

680 LSD Building, Suite 1015

312/695-8486

Bill Grobman, MD (MFM)

Prentice 5-2184

312/472-4685

Cassing Hammond, MD (Fam Plan)

680 LSD Building, Suite 1015

312/695-8486

Ralph Kazer, MD (REI)

676 Building, Suite 1845

312/926-8244

John R. Lurain, MD (Gyn Onc)

Prentice 5-2168

312/472-4683

Magdy P. Milad, MD, MS (REI)

Prentice 5-2176

312/472-4686

Alan Peaceman, MD (MFM)

Prentice 5-2181

312/472-4685

Julian Schink, MD (Gyn Onc)

Prentice 5-2168

312/472-4683

Lee Shulman, MD (Genetics)

Prentice 5-2174

312/472-4684

Melissa Simon, MD (Fam Plan)

680 LSD Building, Suite 1015

312/695-8486

Michael L. Socol, MD (MFM)

Prentice 3-2303

312/472-3970

Ralph Tamura, MD (US)

Prentice 5-2365

312/472-4685

Janelle Walton, MD (MFM)

Prentice 5-2175

312/472-4685

(MFM)

Department of Obstetrics and Gynecology 2012-2013 Senior Elective Courses

1433-41

Maternal-Fetal Medicine, NMH

Dr. Janelle Walton

Maternal-Fetal Medicine Sub-Internship, NMH

Dr. Janelle Walton

1433-42

Gynecologic Oncology, NMH

Dr. Emily Berry

1433-43

Reproductive Endocrinology and Infertility, NMH

Dr. Ralph Kazer

1433-44

Reproductive Genetics, NMH

Dr. Lee Shulman

1433-45

Ambulatory OB-GYN, NMH

Dr. Dana Gossett

1433-46

Research

Various faculty

1433-54

Women’s Health, NMH

Dr. Cassing Hammond